Toledo nursing home appeals state censure

Action keeps Ashland Ave. facility open

11/25/2012

BY KATE GIAMMARISEBLADE STAFF WRITER

Liberty Nursing Center of Toledo was notified in August that it would lose its license — meaning it probably would have to shut its doors — after staff failed to properly respond to an incident of sexual abuse.

A Toledo nursing home warned by the state several months ago that it faces loss of its license for “ongoing failure ... to protect residents from abuse” is still operating and has appealed the action.

Liberty Nursing Center of Toledo, 2005 Ashland Ave. was notified in August that it would lose its license — meaning it probably would have to shut its doors — after an incident in which staff failed to properly respond to an incident of sexual abuse. If a facility’s license is revoked, it can no longer operate.

Liberty has appealed; the Ohio Department of Health will conduct a hearing in Columbus on Dec. 5 and 6. Nursing home license revocations are fairly rare. The state moved three times this year to revoke licenses from Ohio nursing homes; it had not revoked any licenses for the previous five years.

“The closing of a facility does impact all the residents and their families,” said Tessie Pollock, a health department spokesman. “So it is something we take very seriously as a last resort.”

Some of the central-city facility’s approximately 100 residents have moved out, but most still live there, said Stacey Premo, director of the long-term-care ombudsman program at Advocates for Basic Legal Equality Inc., which is helping relocate residents who wish to leave.

In August, Liberty was notified by the department that, barring a substantive change in care quality, its license would be revoked that month. At the same time, the department suggested terminating Liberty’s provider agreement, which would deny it Medicare and Medicaid funding.

According to a letter from the Centers for Medicare & Medicaid Services, the facility’s provider agreement was temporarily terminated, though it was eventually lifted. The facility was fined $103,000 for failure to comply with Medicare and Medicaid regulations.

The facility had a history of problems and was designated a Special Focus Facility by CMS, indicating a history of poor care that warrants stricter monitoring. Recent problems include a December, 2011, incident in which a motorist found a resident wandering without a coat two miles from the facility, a 2009 event in which two patients left the building and allegedly used cocaine and marijuana, and two incidents in which patients jumped out of windows and injured themselves. Each time, Liberty failed to develop care plans for other residents at risk of escape, the health department said.

In the most recent incident, in July, which triggered the license revocation, a male resident diagnosed with schizoaffective disorder, delusions, and sexually aggressive behaviors entered the room of a partially paralyzed female patient. Nurses on duty found him lying on top of the woman with his pants removed and her incontinence brief pushed aside.

Nurses notified the man’s psychiatrist and transferred him to a hospital, but after Liberty staff determined the man had no sexual contact with the victim, an administrator ordered them to “clean up” the woman, and she did not undergo a doctor’s examination. Liberty did not notify her guardians, file an official report with the Toledo Police Department, or notify the health department.

Liberty is different from a typical nursing home in that it also has a large number of nonelderly residents who are there because of severe mental illness.

Scott Sylak, executive director of the Lucas County Mental Health & Recovery Services Board, said he believes other local agencies could absorb Liberty residents if the facility were to close. “If those folks are in our system, we will do our best to get their needs met,” he said.

After next month’s public hearing, a state hearing officer has 30 days to make a recommendation to the director of the Ohio Department of Health on Liberty’s license. Director Theodore Wymyslo in turn has 30 days to make a decision on the facility's license.

Calls to the company’s corporate office were not returned. The chain’s owner, Linda Black-Kurek, is the immediate past president of the Ohio Health Care Association, an industry lobbying group.

Liberty West Nursing Center has two recent findings of “immediate jeopardy” — the most serious finding state inspectors can note. In one incident, in July, the nursing home “failed to provide adequate supervision” for two residents. “This resulted in Immediate Jeopardy when [a resident] jumped 20 feet from a fourth floor window and sustained serious injuries.”

In an incident in March, “the facility failed to protect one resident from being physically abused by a staff member,” state reports note. According to the report, a nurse’s aide “struck [a resident] in the face multiple times with a closed fist,” causing “multiple contusions to the scalp.”

Richard Mollot, executive director of consumer watchdog group the Long Term Care Community Coalition, said the state must balance the need for residents to have quality care with the disruption and difficulty of moving those who have been in the facility for many years and consider it their home.

If Liberty remains open, Mr. Mollot said, the state should consider bringing in third-party temporary management. “By the time they’re closing a facility down, it has to have been pretty bad for a pretty long period of time. It’s not a happy situation, but I’m glad to see the state is taking this case seriously,” Mr. Mollot said.